Brave New Mom

It’s ironic: Just when you’re most joyful at the arrival of your new baby, watching his every smile, drool, pee and poop with adoring attention, you’re probably most distressed to discover your own body out of shape, your sex drive seemingly gone for good and your emotions more touchy than a teen-ager’s.

Welcome to life as a new mom! It takes many of us months to feel “normal” again. (In fact, your life is so altered that your definition of normal might be changed forever.) The truth is that the rate and nature of postpartum recovery can vary greatly, depending on whether or not you had a Cesarean section, how calm or needy your infant may be or how many unrealistic goals you’ve harbored.

Your mantra must be this: Take it easy. The first weeks postpartum are hard for many new moms. “If you’re feeling crummy, remember that you’re not a failure,” says Allan Lichtman, M.D., a Los Angeles obstetrician and gynecologist who is also a clinical professor at the University of Southern California School of Medicine. For support (and a reality check), talk to other new moms from your childbirth-education

Energy

After the rigors of labor, followed by consecutive nights of interrupted sleep, exhaustion is normal. It usually lifts after about three months as you and your new family gradually develop a routine. Get through it by napping, accepting assistance from friends and family (or hired help) and keeping your expectations realistic. In these first weeks, remember that your main job is to care for your newborn and yourself — not to clean the house or be the perfect hostess to the droves of visitors knocking at the door. “I really encourage women to use help and to nap — and to feel good about those choices,” says Los Angeles OB/GYN Allan Lichtman. You cannot let shyness keep you from asking for — or hiring — help at this time. Your sanity depends on it.

Weight

Your body just isn’t the same for several months after pregnancy and childbirth, so give yourself a break and don’t expect it to be. Focus on keeping up healthful eating and exercise habits rather than obsessing about the scale. Buy some flattering clothes and give yourself pep talks. Many women return to their prepregnancy weight within five months of childbirth, but for some it can take nine months to a year or more. The best way to lose the weight is to gradually work exercise back into your daily life. Keep up a diet of fruits, vegetables, whole grains and protein. And remember that breastfeeding can (but does not always) speed up some weight loss.

Breasts

“Big” is probably the best word to describe your breasts during pregnancy and in the early weeks of breastfeeding (and for this reason many women wear a well-fitting nursing bra 24 hours a day). But what about later? They can lose some firmness after childbirth, according to Kathleen Huggins, R.N., M.S., author of The Nursing Mother’s Companion. When weaning occurs, your breasts may seem smaller after so many months of being full of milk. But every woman is different, and much depends on age and genetics.

Bladder Control

Pregnancy stretches your urethra and the ligaments that support your bladder. A vaginal delivery stretches just about every muscle in your pelvis (a Cesarean section won’t affect them). As a result, you might find that you leak urine when you sneeze, cough or laugh. This condition usually disappears within several months, but Kegel exercises — the contracting of the muscles around the vagina — will strengthen the pelvic floor and help you regain bladder control more quickly. In the meantime, you may want to wear sanitary napkins.

Sex Drive

Interest in sex usually takes a nose dive after childbirth. Your body has been nurturing a baby all day, every day, and you’re worn out; lovemaking is likely the last thing on your mind. “A pressure can develop from your partner,” says Lichtman, “but you should only have sex when you want to have sex and because you are ready.” Of course, when one spouse wants to resume sex and the other doesn’t, tension between a couple can arise, requiring a lot of mutual understanding and compromise. It helps to remember that intercourse is not the only path to intimacy; kissing, embracing, massage and pillow talk might be best in the early weeks. And staying close helps. When you are ready, you might be surprised by the pain of intercourse. An episiotomy or perineal tears might be partly to blame. And lowered hormone levels can cause vaginal dryness. Use foreplay, go slowly, and try over-the-counter lubricants. And unless you want another baby, don’t forget contraception!

Flab

The stretching of your abdominal-wall muscles will leave your tummy looking flabby in the weeks after childbirth. Breastfeeding often helps, because it stimulates the hormone oxytocin, which contracts the uterus, as does walking and, eventually (with your doctor’s approval), a more vigorous exercise routine that includes crunches (see our postpartum workout on page 111). Most mothers regain their abdominal muscle tone in about six months, says Lichtman. If you had a Cesarean section, the area around your scar may be numb for many months.

Moods

One minute you’re euphoric, the next you’re sobbing at a sappy TV commercial. Expect a roller coaster of emotions after childbirth, says Steven Dubovsky, M.D., a psychiatrist at the University of Colorado Health Sciences Center in Denver. Not only are your hormones still running high, but your entire life has changed. You have a new identity and more responsibilities. You might be overcome by the magic of childbirth yet (especially if you had a C-section) regret that it did not go as you’d hoped. You may experience love and loneliness. You might feel insecure about being a parent. It’s all normal.

Up to 70 percent of new moms develop postpartum blues: tearfulness, anxiety and mood swings that begin several days after delivery and may last for two weeks to a month. Postpartum blues subsides on its own and does not require medical care.

Postpartum depression is more serious and long-lasting, affecting an estimated 10 percent of new mothers. It often develops about a month after delivery and can persist until a woman gets treatment, Dubovsky says. Mothers with depression experience days filled with profound sadness. They may have dark attitudes about themselves and their babies and have thoughts of suicide. Physical symptoms include lack of appetite and a sleeplessness unrelated to the new baby’s schedule. Call your doctor or midwife if you experience any of these symptoms, and do so immediately if you think you could harm yourself or your baby. Medical care, usually in the form of counseling and/or medication, does help dramatically.

Skin

In the weeks following childbirth, you may notice tiny broken blood vessels on your face, particularly around your eyes or nose. These are caused by the tremendous pushing you did during labor and will disappear within days. Happily, most other skin abnormalities that may have developed during pregnancy will diminish, too.

Your period

It will be many months before your period resumes with any regularity. If you nurse, you might get your period back between one to three months after you begin to wean your baby; if you’re not nursing, your period will probably resume one to four months after you give birth.

So Happy Together

How soon can a new mom exercise? For some, it’s the day after giving birth. Gentle exercises, such as belly breathing and pelvic tilts, may help a new mother relax and feel less stiff and cramped. But after regaining some strength and stamina, finding time for a regular routine can be tricky. New mothers who want to get back in shape may try to exercise when the baby is asleep — but that doesn’t always work with a newborn, whose sleeping schedule is unpredictable. Our solution: five easy exercises, designed by fitness editor Linda Shelton, that you can do with your baby. This way, when it’s baby’s nap time, you can take that much-needed nap, too! This is a progressive training program: As your baby gets heavier, there will more of her to lift, so you’ll need to get stronger. For best results, try to do this 15- to 20-minute workout four to five times per week.

Your first moves

Most new moms, even those who had Cesarean sections, are encouraged to walk the day after giving birth to get the circulation flowing. Here are a few basic, easy exercises you may be able to begin in the first few days postpartum.

Kegels Contract the muscles around the vagina and hold for 10 seconds; then slowly release. Aim for 5 sets of 10 reps at a time; do 3–4 times during the day. Strengthens pelvic-floor muscles and may help prevent incontinence.

Kneel on the floor on all fours, knees under hips and arms under shoulders, back straight; round your spine up toward the ceiling, tucking your tailbone underneath you. Relax your head and neck to fully stretch your back. Return to just past neutral, slightly arching spine, head up. Do 4–6 reps. After 2 weeks, progress to mild strengthening: From the same starting position, lift right leg to hip height and left arm to shoulder height without arching back or rounding shoulders. Lower and repeat with opposite arm and leg. Work up to 8–10 reps, alternating sides. Stretches and strengthens back muscles.

Wall sit

Lean your entire back against a wall with feet separated in front of you. Bend knees, lowering thighs to a parallel position, knees in line with ankles. Hold for 10–15 seconds; build up to 30 seconds. When you can hold this squat position for 30 seconds, alternately straighten one leg out in front of you to hip height and hold for a count of 5; keep back against the wall. Begin with 5 reps and build to 10 (1 rep equals 1 leg lift). Strengthens quadriceps.

Mom and baby workout

With your doctor’s approval, you may be able to take long walks and add a strengthening workout to the above-mentioned moves at six weeks postpartum (or earlier if all bleeding has stopped, your scars are healing well and you have sufficient energy). The following exercises are designed to increase overall body strength, which will not only help get you back into shape but may also prevent aches and pains, including back strain, as your baby grows. The moves are simple and can be done in the comfort of your home. Equipment needed: one happy baby.

The Exercises

1. Baby ride

Lie on your back with your knees bent and feet flat on the floor, hip-width apart. Hold your baby under her armpits, legs straddling you just above your pubic bone [A]. Contract your abdominals and tilt your pelvis to curl your tailbone, buttocks and lower back off the floor, contracting your buttocks at the top of the lift [B]. Release and lower your hips. Do 2 sets of 8 reps. Strengthens abdominals, buttocks, lower back, inner and outer thighs, and ankle flexors.

Variations:

1. Toes off floor and flexed upward. 2. Open and close knees with toes flexed and off floor. Do 2 sets of 8 of each variation, building to 3 sets of 8. Strengthens quadriceps, buttocks, hamstrings, lower back and abdominals.

2. Baby crunches

Sit on the floor with your knees bent and feet flat on the floor. Place your baby on your lower legs, with her chest facing you, holding her under her armpits for support. Gently contract your abdominals, tilt your pelvis and roll backward until you’re lying flat on the floor with your baby still on your shins and your knees pulled close to your chest [A]. Curl your head, neck and shoulders up and forward off the floor; exhale at the top of the lift [B]. Inhale, return to starting position and repeat. Do 2 sets of 8 reps, building to 4 sets of 8. Strengthens abdominals.

3. Kiss the baby push-ups

Get on your hands and knees, arms straight and slightly in front of your shoulders, with knees behind your hips and your baby lying on the floor between your hands. Contract your abs so your head, neck, spine and hips form one straight line [A]. Inhale and bend elbows out to sides; lower yourself to kiss your baby [B]. Exhale, push yourself back up to the starting position and repeat. Training tip: Lift and lower your body in one straight line without collapsing. Do l set of 8 reps, building to 2 sets of 8. Strengthens chest, front shoulders and triceps.

4. Sit squats

Stand with your back to the seat of a chair, feet hip-width apart, legs straight but not locked. Hold your baby to your chest with your hands. Contract your abdominals so your tailbone points toward the floor and squeeze shoulder blades together [A]. Keeping your back straight and your body weight back toward your heels, bend your knees, lowering your torso into a squat as if to sit down. Your torso will lean forward slightly [B]. When the backs of your thighs barely touch the chair, straighten legs to starting position; repeat. Do 1 set of 12 reps, building to 2 or 3 sets of 12. Strengthens quadriceps, hamstrings and buttocks.

5. Bend-overs

Sit on the edge of a chair with feet wider than hip width. With baby in your arms, abs tight and chest lifted, lean forward from hips, keeping back straight and lowering baby toward floor [A]. Keeping abs tight and back straight, return to a vertical seated position, bringing baby up with you [B]. Repeat. Do 1 set of 8 reps, building to 2 sets of 8. Strengthens back and legs.